[A reduction technique for the treatment of refractory femoral trochanteric fracture].

OBJECTIVE

To explore the effect of periosteal stripper through spiral blade incision combined with lateral sight bracket prying method in the treatment of irreducible femoral trochanteric fractures with proximal upwarping of fracture.

METHODS

From March 2015 to October 2017, 26 patients with refractory femoral trochanteric fractures with proximal upwarp of fracture were treated by periosteal dissection through a spiral blade incision and lateral sight bracket prying, included 9 males and 17 females with an average age of (76.3±8.4) years old ranged from 63 to 85 years old. According to OA/OTA classification, 5 cases were type A1.3 fracture, 6 cases were A2.1, 7 cases were A2.2, 8 cases were A2.3. All cases were closed fractures. The amount of bleeding during operation and the time of fracture healing were observed and recorded. The Harris score of the hip joint function was performed.

RESULTS

All cases were followed up from 7 to 26 months with an average of (17.4±4.7) months. Bone union time was from 9 to 15 months with an average of(12.4±3.5)weeks according to X-rays. At the final follow-up, Harris scores were 86 to 93 points with an average of (85.8±5.6) points, 23 cases were classified as excellent, 2 as good, and 1 as fair.

CONCLUSIONS

Using periosteum stripper through spiral blade incision combined lateral sight bracket prying for the treatment of irreducible femoral trochanteric fracture, the reduction effect is accurate, the operation time is shortened obviously, no auxiliary small incision is needed, the clinical effect is good, the reduction technique is simple and practical.